Purpose: The aim of this 1-year prospective study was to evaluate, in patients with severe periodontitis, the clinical performance of implants placed immediately after extraction of remaining teeth or in healed sockets and immediately loaded for prosthetic oral rehabilitation, and to compare the clinical outcomes for implants placed in fresh extraction sockets versus healed sites. Materials and Methods: All patients in this study had received periodontal treatment; however, the teeth were eventually deemed hopeless. The remaining teeth were extracted, the periodontally compromised sites were débrided, implants were inserted guided by a surgical template, and a provisional restoration was delivered immediately. The opposing arch was restored with a complete denture. Definitive prostheses were inserted after 6 months. Initial implant and prosthesis stability and the inflammatory response were evaluated. Clinical and radiographic analyses were performed. Results: A total of 84 rough-surfaced implants were placed (50 in the maxilla and 34 in the mandible). Of these, 32 were placed in fresh extraction sockets. Four implants in three patients failed within the first 6 months, resulting in an implant survival rate of 95.2%. All of the failed implants had been placed in fresh maxillary extraction sockets. The survival rates were 92% (46/50) in the maxilla and 100% (34/34) in the mandible. Prosthetic success was 100%. The mean bone level change (± SE) between baseline and 12 months was -1.12 ± 0.18 mm. There were no statistically significant differences in insertion torque and alveolar bone loss between postextraction sites and healed sites. Conclusions: The implant failure rate was higher in maxillary postextraction sites. This indicates a heightened risk of failure for immediate implants placed in periodontally compromised maxillae. Nevertheless, a satisfactory prosthetic success was achieved after 1 year. Schlagwörter: dental implants, full-arch reconstruction, immediate loading, immediate placement, periodontal disease